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Individual

DR. REBECCA ELIZABETH CROCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
5105 SOM CENTER ROAD, SUITE 201, WILLOUGHBY, OH 44094
(440) 602-6710
(440) 269-8107
Mailing address
7590 AUBURN RD STE 14, CONCORD TWP, OH 44077-9176
(440) 354-1899
(440) 354-1845

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34.009381
OH
207V00000X
Obstetrics & Gynecology Physician
58.001481
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2867858
OH
Enumeration date
06/05/2008
Last updated
03/03/2021
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